Delusions of failure

Published February 4, 2014 - 1:03am

By PAUL KRUGMANNew York Times News Service

The Republican response to the State of the Union address was delivered by Rep. Cathy McMorris Rodgers, R-Wash. — and it was remarkable for its lack of content. A bit of uplifting personal biography, a check list of good things her party wants to happen with no hint of how it plans to make them happen.

The closest she came to substance was when she described a constituent, “Bette in Spokane,” who supposedly faced a $700-a-month premium hike after her health insurance policy was canceled. “This law is not working,” intoned McMorris Rodgers. And right there we see a perfect illustration of just how Republicans are trying to deceive voters — and are, in the process, deceiving themselves.

I’ll get back to “Bette in Spokane” in a minute, but first, is Obamacare “not working”?

Everyone knows about the disastrous rollout, but that was months ago. Since then, health reform has been steadily making up lost ground. At this point enrollments in the health exchanges are only about 1 million below Congressional Budget Office projections, and rising faster than projected. So a best guess is that by the time 2014 enrollment closes on March 31, there will be more than 6 million Americans signed up through the exchanges, versus 7 million projected. Sign-ups might even meet the projection.

But isn’t Obamacare in a “death spiral,” in which only the old and sick are signing up, so that premiums will soon soar? Not according to the people who should know — the insurance companies. True, one company, Humana, says the risk pool is worse than it expected. But others, including WellPoint and Aetna, are optimistic (which isn’t a contradiction: different companies could be having different experiences). And the Kaiser Family Foundation, which has run the numbers, finds that even a bad risk pool would have only a minor effect on premiums.

Now, some, perhaps many, of those signing up on the exchanges aren’t newly insured; they’re replacing their existing policies, either voluntarily or because those policies didn’t meet the law’s standards. But those standards are there for a reason — the same reason health insurance is now mandatory. Health reform won’t work if people go uninsured, then sign up when they get sick. It also can’t work if healthy people only buy fig-leaf insurance, which offers hardly any coverage.

And what this means, in turn, is that while we don’t know yet how many people will be newly insured under reform, we do know that even those who already had insurance are, on average, getting much better insurance. Since the goal of health reform was to make Americans more secure — to reduce their risk of being unable to afford needed health care, or of facing financial ruin if they get sick — the law is doing its job.

Which brings me back to Bette in Spokane.

Bette’s tale had policy wonks scratching their heads; it was hard to see, given what we know about premiums and how the health law works, how anyone could face that large a rate increase. Sure enough, when a local newspaper, The Spokesman-Review, contacted Bette Grenier, it discovered that the real story was very different from the image McMorris Rodgers conveyed. First of all, she was comparing her previous policy with one of the pricier alternatives her insurance company was offering — and she refused to look for cheaper alternatives on the Washington insurance exchange, declaring, “I wouldn’t go on that Obama website.”

Even more important, all Grenier and her husband had before was a minimalist insurance plan, with a $10,000 deductible, offering very little financial protection. So yes, the new law requires that they spend more, but they would get far better coverage in return.

So was this the best story McMorris Rodgers could come up with? The answer, probably, is yes, since just about every tale of health reform horror the GOP has tried to peddle has similarly fallen apart once the details were revealed. The truth is that the campaign against Obamacare relies on misleading stories at best, and often on outright deceit.

Who pays the price for this deceit? In many cases, American families. Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing.

But conservative politicians aren’t just deceiving their constituents; they’re also deceiving themselves. Right now, Republican political strategy seems to be to stall on every issue, and reap the rewards from Obamacare’s inevitable collapse. Well, Obamacare isn’t collapsing — it’s recovering pretty well from a terrible start. And by the time that reality sinks in on the right, health reform will be irreversible.

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